Individual
AMBER N PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-3735
(262) 884-4000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 884-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100163798
—
WI
Enumeration date
06/11/2020
Last updated
01/13/2025
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